热带岛屿工作对高血压患者血压影响及相关干预分析

目的 研究热带岛屿工作期间高血压患者血压变化和影响因素,及护理干预后的疗效。方法 动态监测入组高血压患者血压变化,调查分析相关影响因素,进而给予规律用药、心理辅导、调节饮食结构、规范作息时间、养成良好生活习惯等护理干预。结果 连续驻岛工作3个月后监测入组患者血压[收缩压（142.9±8.4）mmHg,舒张压（89.5±11.3）mmHg],较其在岸上血压[收缩压（122.4±6.7）mmHg,舒张压（81.3±4.8）mmHg]高,因素分析显示血压波动与热带高温、高湿环境、规律用药、规律作息、饮食结构、吸烟相关。通过3个月用药、心理、饮食、运动及健康宣教等综合护理干预,干预前[收缩压（142.9±8.4）mmHg,舒张压（89.5±11.3）mmHg],干预后[收缩压(131.2±7.3）mmHg,舒张压（81.6±4.1）mmHg],高血压患者血压明显下降。结论 热带岛屿特殊工作环境对血压波动有一定的影响,系统性的护理干预能够有效的控制血压,减轻症状,维护身心健康。     

治疗高血压记住五个"三"

现将治疗高血压的有关知识归纳为5个"三",以便于高血压患者记忆和实践。血压程度分三级世界卫生组织对高血压规定为三级:1级高血压(轻度):收缩压140～159mmHg,舒张压90～99mmHg;2级高血压(中度):收缩压160～179mmHg,舒张压100～109mmHg;3级高血压(重     

高血压患者运动试验风险因素探讨

目的:初步探讨高血压患者运动试验中的风险因素。方法:选取国家体育总局运动医学研究所体育医院门诊高血压患者98例,进行心电图平板运动试验。将患者按照既往运动习惯分为运动组(n=52)和运动不足组(每周运动少于3次,每次少于30 min,n=46);将患者按照运动试验终止时出现的风险因素分组:(1)收缩压显著增高组(运动中最大收缩压≥220 mmHg,n=28)及其对照组(运动中最大收缩压<220 mmHg,n=70);(2)舒张压显著增高组(运动中最大舒张压≥110mmHg,n=30)及其对照组(运动中最大舒张压<110 mmHg,n=68);(3)ST段降低组(运动中ST段降低≥1 mm,n=20)及其对照组(运动中ST段降低不足1 mm或未见降低,n=78)。分别比较上述三组及其对照组安静时、运动中以及恢复期心率、血压的变化情况。结果:(1)运动组高血压患者安静时和运动时最高舒张压显著低于运动不足组(P=0.019,P=0.029)。(2)运动试验中,收缩压显著增高组和舒张压显著增高组安静时舒张压分别显著高于各自对照组(P=0.00,P=0.00),且收缩压和舒张压显著增高组安静时舒张压均值均高于临床诊断标准(90 mmHg)。(3)运动试验中ST段降低组运动后2分钟收缩压恢复率(rSBP)显著高于其对照组(P=0.006)。结论:(1)参与规律体育锻炼的高血压患者运动前及运动中的舒张压较低。(2)运动前舒张压控制不佳的高血压患者运动中易发生风险。(3)运动后收缩压恢复率可作为提示高血压患者运动风险的指标。     

肾动脉狭窄支架术对肾功能和血压的作用

目的　评估经皮肾动脉支架术对肾动脉狭窄患者肾功能和血压的改善作用。方法　入选 87例单侧或双侧肾动脉明显狭窄 (管腔内径减少 >70 % )行经皮腔内肾动脉支架术患者。比较各例术前、术后4 8h及随访期血清肌酐、肾小球滤过率 (GFR)及血压变化。结果　 87例患者 (98处病变 )均成功植入肾动脉支架。术后 4 8h平均血清肌酐较术前轻微升高 [术前 (176± 2 1) μmol/L和术后 (179± 11) μmol/L ,P =0 .15 ) ,但术后 6个月随访平均血清肌酐较术前显著降低 [(14 9± 15 ) μmol/L ,比较术前P <0 .0 0 1]。术后 6个月 ,GFR显著增加 [(5 1± 8)ml/min和 (37± 11)mL/min ,P <0 .0 0 1],且 6 1%患者血清肌酐测值恢复正常。收缩压及舒张压显著降低 [术前 :(16 3± 2 3/ 96± 13)mmHg ,术后 6个月 :(14 8± 12 / 79± 15 )mmHg ,P均 <0 .0 0 1) ,6 7%患者术后 6个月血压控制良好。结论　经皮肾动脉支架术手术成功率高 ,其对患者肾功能及控制血压具明显改善作用。     

长期应用非洛地平对原发性高血压患者血管内皮功能的影响

目的观察长期应用非洛地平对原发性高血压患者血管内皮功能的影响。方法60例轻-中度原发性高血压患者给予非洛地平口服治疗24周。采用高分辨率血管外超声法检测治疗前后肱动脉内皮依赖性血管舒张功能。结果非洛地平治疗24周后,原发性高血压患者的收缩压[(122.8±11.7)mmHg]及舒张压[(76.4±8.2)mmHg]均较治疗前[收缩压:(160.4±14.8)mmHg,舒张压:(96.2±10.1)mmHg]显著降低(均P<0.01);治疗后肱动脉内径的基础值[(4.98±0.41)mm]及血流介导的内皮依赖性舒张功能[(6.21±1.28)%]均较治疗前[(分别为(4.02±0.50)mm和(4.91±1.03)%]明显改善(均P<0.01)。结论非洛地平能够在有效降压的同时显著改善原发性高血压患者肱动脉内皮依赖性舒张功能。     

厄贝沙坦对老年原发性高血压左心室肥厚患者血压变异性的影响

目的观察厄贝沙坦对老年原发性高血压(以下简称高血压)左室肥厚患者血压变异性和左心室重构的影响。方法选取50例老年高血压、左室肥厚的患者,服用厄贝沙坦3个月,观察服药前后日间收缩压、舒张压,夜间收缩压、舒张压,24 h收缩压、舒张压的变化,并比较超声心动图参数,舒张期室间隔厚度(IVST)、舒张期左心室后壁厚度(LVPWT)、左心室舒张末期内径(LVEDd)和左心室质量指数(LVMI)的变化。结果服药3月后,患者的日间收缩压、舒张压,夜间收缩压、舒张压,24 h收缩压、舒张压均较治疗前明显下降(P<0.01);IVST、LVPWT、LVEDd及LVMI也呈显著性下降(P<0.01)。结论厄贝沙坦能够降低老年高血压左室肥厚患者的血压变异性,抑制心室重构,改善预后。     

高血压治疗新进展

高血压是一种以动脉血压持续升高为主要表现的慢性疾病,常引起心、脑、肾等重要器官的病变.本文参考国内外一些文献资料,综述如下: 1 治疗目标 1.1 一般高血压患者140/90 mmHg以下;65岁以上患者:收缩压150 mmHg以下;伴有肾脏疾病、糖尿病或病情稳定的冠心病高血压患者:130/80 mmHg以下;脑卒中后高血压患者:140/90 mmHg以下;处于急性期的冠心病或脑卒中患者:按照指南进行降压;舒张压低于60 mmHg的冠心病患者:逐步实现收缩压达标[1].     

硝苯地平控释片治疗老年性高血压的临床疗效评价

目的　观察硝苯地平控释片对老年高血压治疗的临床疗效。方法　本研究采用 2 4h动态血压、超声心动图和平板运动的检查 ,评价硝苯地平控释片对老年高血压患者左室肥厚和运动血压的影响 ,3 6例按WHO标准确诊为老年高血压者 ,排除继发性高血压 ,停降压药 2周后给硝苯地平控释片 ,初始剂量为 3 0mg/d ,晨 8:0 0服 ,1周末有 6例未达显效而增量为 60mg/d治疗 4个月。观察治疗前后 2 4h动态血压 ,超声心动图和平板运动实验结果。结果　硝苯地平控释片治疗后 2 4h收缩压、舒张压及白昼夜间收缩压、舒张压均明显低于治疗前 ;左室质量、室间隔厚度及左室后壁厚度也明显减少 ;治疗后运动高峰时收缩压、运动停止后 3min收缩压亦明显降低。结论　硝苯地平控释片能有效降低老年高血压患者 2 4h收缩压、舒张压 ,逆转左室肥厚 ,并明显降低运动时收缩压 ,但对运动时舒张压及血压昼夜节律无明显影响     

社区护理对临界高血压患者血压的影响研究

目的探讨社区护理干预对临界高血压患者血压的影响。方法将106例患者随机分为对照组和实验组,每组53例,对照组不用药物治疗采用随访观察,对实验组患者采用健康教育、心理干预、指导血压监测,定期随访护理干预等措施,随访时做好记录,6个月后比较两组患者的收缩压和舒张压变化情况。结果实验组患者的收缩压和舒张压在护理干预前与对照组比较差异无统计学意义（P〉0.05）,实验组患者的收缩压和舒张压在护理干预后血压下降情况好于对照组,两组比较差异有统计学意义（P〈0.05）。结论对临界高血压患者进行社区护理干预,可以提高患者的自我保健意识,有效的控制血压,能够有效预防高血压的发展,改善患者的生活质量。     

高血压治疗新进展

高血压是一种以动脉血压持续升高为主要表现的慢性疾病,常引起心、脑、肾等重要器官的病变。本文参考国内外一些文献资料,综述如下:1治疗目标1.1一般高血压患者140/90 mmHg以下;65岁以上患者:收缩压150 mmHg以下;伴有肾脏疾病、糖尿病或病情稳定的冠心病高血压患者:130/80 mmHg以下;脑卒中后高血压患者:140/90 mmHg以下;处于急性期的冠心病或脑卒中患者:按照指南进行降压;舒张压低于60 mmHg的冠心病患[1]     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.